Factors Related to a Delay in Seeking Treatment for Acute Myocardial.pdf

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553 Vol . 24 No. 4 Correspondence to: Samoraphop Banharak *, RN, PhD, Assistant Professor, Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand. E-mail: [email protected] Channarong Prasankok , RN, MNS, Cardiac Nurse, Queen Sirikit Heart Center of Northeast, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. E-mail: [email protected] Helen W. Lach , RN, PhD, Professor, Trudy Busch Valentine School of Nursing, Saint Louis University, St. Louis, MO, USA. E-mail: [email protected] Factors Related to a Delay in Seeking Treatment for Acute Myocardial Infarction in Older Adults: An Integrative Review Samoraphop Banharak*, Channarong Prasankok, Helen W. Lach Abstract: Acute myocardial infarction is a significant world-wide problem, especially among older adults. More than 50% of older adults who experience this die before arriving at the hospital because of delaying seeking treatment. The aim of this integrative review was to describe factors related to a delay in seeking treatment among older adults with acute myocardial infarction. Studies published up to 2019 were extracted from the literature that dealt with a delay in treatment for acute myocardial infarction. These needed to be published in peer reviewed English or Thai journals or thesis/dissertations; and involved studies where at least 75% of participants were over 55 years. However, studies without comparisons about factors related to delay treatment were excluded. A total of 23 papers were selected for final review following standard methods for an integrative review. Results revealed three phases related to delays in seeking treatment: patient/bystander recognition action, transportation, and hospital action phases. Most older adults spent the longest average of time delaying in the first phase. Factors associated with delay seeking treatment were in four categories: socio-demographic (advanced age, female, non-white, single/widowed/ separated, low education, and low income) ; physiological and environmental (using private car, living alone, experiencing symptoms at home/weekday/night, and living in impoverished/ rural area); psychological and behavioral (feelings and thoughts hesitancy/ambiguity/bother and self-management); and clinical (lack of cardiac history, positive history of diabetes mellitus, hypertension, stroke, heart failure, angina pectoris, smoking, and symptoms mismatch/low intensity/ atypical symptoms). Findings suggest that nurses need to educate older populations about the early recognition of acute myocardial infarction symptoms and tailor interventions to improve understanding of symptoms and need for emergency treatment. Pacific Rim Int J Nurs Res 2020; 24(4) 553-568 Keywords : Acute myocardial infarction, Integrative review, Older adults, Time-to-treatment, Treatment delay Introduction Acute myocardial infarction (AMI) occurs when the heart muscle lacks sufficient blood supply due to one or more blocked coronary arteries 1 . This event results in a high rate of hospital admissions, creates

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